Internal Maxillary Artery to M2 Middle Cerebral Artery Bypass With Modified Superficial Temporal Artery Graft: 3-Dimensional Operative Video

2017 ◽  
Vol 13 (2) ◽  
pp. 280-280 ◽  
Author(s):  
Arnau Benet ◽  
Ali Tayebi Meybodi ◽  
Xuequan Feng ◽  
Michael T. Lawton
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Artery Bypass ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Maxillary Artery ◽  
Internal Maxillary Artery ◽  
3 Dimensional ◽  
Artery Graft

Management of Early Intraoperative Superficial Temporal Artery to Middle Cerebral Artery Bypass Occlusion in a Moyamoya Patient: 3-Dimensional Operative Video

2017 ◽  
Vol 14 (4) ◽  
pp. 459-460
Author(s):  
Pedro Ribeiro da Cunha ◽  
Jonadab Dos Santos Silva ◽  
Arnau Benet ◽  
Jan-Karl Burkhardt ◽  
Halima Tabani ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Artery Bypass ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
3 Dimensional

Surgical Technique for High-Flow Internal Maxillary Artery to Middle Cerebral Artery Bypass Using a Superficial Temporal Artery Interposition Graft

2017 ◽  
Vol 13 (2) ◽  
pp. 246-257 ◽  
Author(s):  
Xuequan Feng ◽  
Ali Tayebi Meybodi ◽  
Jordina Rincon-Torroella ◽  
Ivan H. El-Sayed ◽  
Michael T. Lawton ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
High Flow ◽  
Maxillary Artery ◽  
Internal Maxillary Artery ◽  
Middle Fossa ◽  
Middle Fossa Approach ◽  
Interposition Graft

Abstract BACKGROUND: Extracranial-to-intracranial high-flow bypass often requires cranial, cervical, and graft site incisions. The internal maxillary artery (IMA) has been proposed as a donor to decrease invasiveness, but its length is insufficient for direct intracranial bypass. We report interposition of a superficial temporal artery (STA) graft for high-flow IMA to middle cerebral artery (MCA) bypass using a middle fossa approach. OBJECTIVE: To assess the feasibility of an IMA–STA graft-MCA bypass using a new middle fossa approach. METHODS: Twelve specimens were studied. A 7.5-cm STA graft was obtained starting 1.5 cm below the zygomatic arch. The calibers of STA were measured. After a pterional craniotomy, the IMA was isolated inside the infratemporal fossa through a craniectomy within the lateral triangle (lateral to the posterolateral triangle) in the middle fossa and transposed for proximal end-to-end anastomosis to the STA. The Sylvian fissure was split exposing the insular segment of the MCA, and an STA-M2 end-to-side anastomosis was completed. Finally, the length of graft vessel was measured. RESULTS: Average diameters of the proximal and distal STA ends were 2.3 ± 0.2 and 2.0 ± 0.1 mm, respectively. At the anastomosis site, the diameter of the IMA was 2.4 ± 0.6 mm, and the MCA diameter was 2.3 ± 0.3 mm. The length of STA graft required was 56.0 ± 5.9 mm. CONCLUSION: The STA can be used as an interposition graft for high-flow IMA–MCA bypass if the STA is obtained 1.5 cm below the zygomatic arch and the IMA is harvested through the proposed approach. This procedure may provide an efficient and less invasive alternative for high-flow EC–IC bypass.

A 1-Donor 2-Recipient Superficial Temporal Artery-Middle Cerebral Artery Bypass for Moyamoya Syndrome: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Nickalus R Khan ◽  
Jacques J Morcos
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Artery Bypass ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Surgical Anatomy ◽  
Large Area ◽  
Ischemic Disease ◽  
Near Occlusion ◽  
Direct Bypass

Abstract We present the case of a 34-yr-old male who suffered repeated ischemic events resulting in right-sided weakness. He was found to have left M1 segment near occlusion on angiography with a large area of uncompensated hypoperfusion. The patient underwent a direct superficial temporal artery-middle cerebral artery (STA-MCA) bypass. Direct bypass in the acute setting of ischemia has been previously described.1-5 Moyamoya ischemic disease can be treated with either direct or indirect surgical revascularization. There have been several techniques developed for direct bypasses in moyamoya ischemic disease. These include the standard 1-donor 1-recipient (1D1R) end-to-side (ES) bypass, the “double-barrel” 2-donor 2-recipient (2D2R) ES bypass, and the more recently developed 1-donor 2-recipient (1D2R)6,7 utilizing both an ES and a side-to-side (SS) bypass with a 1-donor vessel. The case presentation, surgical anatomy, decision-making, operative nuances, and postoperative course and outcome are reviewed. The patient gave verbal consent for participating in the procedure and surgical video.

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